New Search
OMB APPROVAL NO. PAGE OF <br /> REQUEST FOR ADVANCE 0348-0004 1 2 PAGES <br /> a. '7C"one orboth boxes 2. BASIS OF REQUEST <br /> OR REIMBURSEMENT ?ADVANCE ® REIMBURSE. <br /> TvPEOF MENT ? CASH <br /> PAYMENT b. 'x" the applicable box <br /> (See instructions on back) REQUESTED ®ACCRUAL <br /> Qi FINAL ? PARTIAL <br /> 3. FEDERAL SPONSORING AGENCY AND ORGANIZATIONAL ELEMENT TO 4. FEDERAL GRANTOR OTHER 5. PARTIAL PAYMENT REQUEST <br /> WHICH THIS REPORT IS SUBMITTED IDENTIFYING NUMBER ASSIGNED NUMBER FOR THIS REQUEST <br /> BY FEDERAL AGENCY <br /> U.S. Bureau of Land Management HEF041 M07 1 <br /> B. EMPLOYER IDENTIFICATION; 7. RECIPIENTS ACCOUNT NUMBER 8. PERIOD COVERED BY THIS REQUEST <br /> i <br /> NUMBER OR IDENTIFYING NUMBER FROM (month, day, year) TO (month, day, year) <br /> ~ 93-6002160 1536-0031-8601 October 27, 2004 June 30, 2005 <br /> 9. RECIPfENT ORGANIZATION 10. PAYEE (Where Check is f0 be sent!( different than Item 9) <br /> Name: City of Eugene Name: <br /> Number Number <br /> and street: 777 Pearl Street and street: <br /> i <br /> city, state Eu ene, OR 97401 city, state ' <br /> i and ZlP Code: 9 and Z!P Code: <br /> I ' <br /> ~ 11. COMPUTATION OF AMOUNT OF REIMBURSEMENTS/ADVANCES REQUESTED <br /> PROGRAMS/FUNCTIONS/ACTIVITIES ? (a) (b) (c) <br /> Fuels reduction TOTAL <br /> a. Total program (As of date) <br /> outia to date $ 13,000.00 $ $ $ 13,000.00 <br /> <br /> ~ b. Less: cumulative ro ram income 0.00 0.00 <br /> c. Net program outlays (Line a mfnus <br /> line b 13,000.00 0.00 0.00 13,000.00 <br /> d. Estimated net cash outlays for advance 0.00 <br /> riod <br /> e. Total (sum oPlines c ~ d) 13,000.00 0.00 0.00 13,000.00 <br /> f. Non-Federal share of amount on line a 0.00 0,00 <br /> . Federal share of amount on line a 13,000.00 13,000.00 <br /> h. Federal a ments reviousl re uested 0.00 0,00 <br /> i. Federal share now requested (Line g <br /> minusllneb ~ 13,000.00 0.00 0.00 13,000.00 <br /> <br /> ' j• Advances required by <br /> month, when requested 1st month 0,00 <br /> by Federal grantor <br /> agency for use In making 2nd month 0,00 <br /> prescheduledadvances 3rd month 0,00 <br /> 12. ALTERNATE COMPUTATION FOR ADVANCES ONLY <br /> a. Estimated Federal cash outla s that will be made Burin eriod covered b the advance $ 0.00 <br /> b. Less: Estimated balance of Federal cash on hand as of be innln of advance eriod <br /> c. Amount re uested (L/ne a minus line b) $ Q,QQ <br /> AUTHORIZED FOR LOCAL REPRODUCTION (Continued on Reverse) srArtDARD FORM 2~0 (Rev. ~-s~ <br /> Prescribed by OMB Circulars A-102 and A-110 <br /> <br />